NURS 6660N Final Exam-2 Versions 150 Questions & Answers Latest Update 2022/2023, Exams of Nursing

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NURS 6660N Final Exam-2 Versions 150

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NURS 6660N Final Exam-2 Versions 150

Questions & Answers Latest Update

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NURS 6660N Final Exam-2 Versions 150

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Conventional antipsychotics are not first-line interventions in early- onset schizophrenia due to the risk of dystonic reactions. However, when children are not responsive to first-line therapy with atypical antipsychotics, which of the following is the most appropriate conventional choice?

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D.

Chlorprom az ine The therapeutic outcomes for children with disorders of written expression are mostfavorable when they are characterized by:

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Intensive, continuous administration of individually tailored, one-on- oneexpressive and creative writing therapy

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NURS 6660N Final Exam-2 Versions 150 Questions & Answers Latest Update 2022/

Linda is a 5-year-old girl who has persistent pica; she was finally referred for care when her kindergarten teacher became alarmed by her eating of potentially toxic nonfood substances. Linda’s mother admits during the history that Linda has been doing this foryears, but thought it was not a big deal since Linda didn’t eat anything dangerous. Linda’s mother must work two jobs and essentially did not bother to pursue Linda’s unusual symptom because it didn’t seem unsafe. While discussing management strategies with Linda’s mother, the PMHNP counsels that the most rapidly successfultreatment strategy appears to be:

Selecte

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A.

Aversi o n therap y Rumination is a feeding disorder most commonly seen in infants, but it can occur at anypoint in the lifespan. Characteristic findings in infants include:

Selecte

d

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C.

Failure tothrive Katelyn is a16-year-old girl who presents for therapy with her mother and father. Katelyn was born with male genitalia but has felt like a female “all of her life.” She says she knewsomething was different as far back as she can remember. She always wanted to wearher mother’s clothes and makeup and play with other girls. Katelyn started dressing and openly identifying as a girl when she was 13 years old, and her parents are trying to be supportive but they are struggling. Most recently Katelyn has developed an intimate partner relationship with Jennifer, a 15-year-old girl who was gender-assigned female at birth and identifies as a female. Katelyn’s father does not understand the relationship. The PMHNP explains that Katelyn:

NURS 6660N Final Exam-2 Versions 150

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Answer: Is^ a^ transgender^ female^ who^ identifies^ aslesbian

All the following are true with respect to making a diagnosis of major depressive disorderin

Selected Answer:C.

There must be somatic or psychomotor complaints. Donna is a 16-year-old transgender female who has been through extensive individual

NURS 6660N Final Exam-2 Versions 150 Questions & Answers Latest Update 2022/

Selected C.

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Sterility is a probable consequenceof hormone therapy

Cameron is a 7-year-old boy who has been diagnosed with ADHD and started on

psychostimulants. Two months later there has been no meaningful improvement of symptoms,

and he is referred from primary care to a PMHNP. While reviewing his records, the PMHNP notes

that Cameron has been living with his aunt and uncle and their four

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children since the death of his mother 6 months ago. Cameron, who reportedly was always a

happy and well-adjusted only child, developed symptoms shortly after these major life

changes. His symptoms were characterized primarily by temper tantrums and an inability to sit

still. He is not functioning well in school and is having repeated stomachaches and headaches.

The PMHNP considers that the most appropriate action would be to stop the psychostimulant

and assess Cameron for:

Selecte

d

Answer

:

B.

Agitated depression

The PMHNP is working with a pediatrician colleague on a journal article to increase awareness and improve diagnostic strategies for early-onset bipolar disorder. Based upona review of the longitudinal research on this disorder, the literature review of this article should include all the following except:

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e d

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C.

Higher socioeconomic status and lifetime psychosis are predictors of more rapid cycling in early-onset bipolar disorder Tiana is a 10-year-old girl who is being referred for evaluation because her school performance is appreciably below what is expected at her age. Historically she has beena very happy child, likes school, and looks forward to going. However, over the

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last several months her teacher reports that she is much slower than her peers in reading, and she appears to be upset and withdrawn when asked to read in class. The PMHNP would expect additional report from the teacher to include all the following except:

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A.

Inability to copy correctly from aprinted text Which of the following statements best characterized the treatment course and progression of bulimia nervosa?

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d

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A.

Cognitive behavioral therapy is considered the benchmark, first-line treatment.

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Kelly is a 14-year-old female who has finally been referred for management of anorexia nervosa. She was diagnosed almost 1 year ago with the food-restricting subtype, but attempts to get her into psychiatric care were unsuccessful. She continues to be resistant but her caloric intake is now < 400 daily and she finally appears to be unable to sustainthe supraphysiologic levels of exercise that she has maintained to try and “keep her weight down.” She is 5’2” tall and weighs 82 lbs., which is approximately 75% of ideal body weight for her height. Her vital signs are stable and surprisingly there are no profound laboratory or ECG abnormalities. When counseling Kelly and her parents aboutthe recommended course of treatment, the PMHNP advises that Kelly will require:

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B.

Hospitalization for controlledweight gain In which demographic is depression twice as prevalent in girls as compared to boys?

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C.

Adolesce n ts Debbie is a 10-year-old female who has been referred to remediation therapy for her reading disorder. While designing her treatment program, the PMHNP knows that the most current strategies are characterized by:

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C.

Focusing the child’s attention to the connections between speech sounds and spelling

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Selected Answer:D.

Pervasive anhedonia, hopelessness, and severe psychomotorretardation The etiology of childhood depression is multifactorial and may include biological factors

Selecte d Answer:A.

Prepubertal children having a depressive episode secrete significantly more

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Which of the following symptom clusters is most likely in a 16-year-old male with majordepressive disorder?

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Jared is a 6-year-old boy who comes to the PMHNP for an evaluation with his father. Thefather reports that he is worried about Jared because he has had problems fitting in at school ever since he started kindergarten. He does not have any friends at school and does not seem to know how to play with others. Dad reports that Jared has never been “very talkative” and sometimes switches from one topic to another without any reason.When considering early-onset schizophrenia, the PMHNP recognizes that which of the following must be present?

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B.

Deteriorating function over the last several months Learning disorders affect at least 5% of all school-aged children in the United States. Since 1975, Public Law 94-142 mandates that all states provide free, appropriate servicesto all children. Among the various types of learning disorders, the PMHNP knows that the overwhelming majority are:

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A.

Reading disorders While the core features of schizophrenia are essentially the same in children as they arein adults, the presentation or characterization is sometimes very different given developmental issues. Unlike adults with schizophrenia, children with schizophrenia do not have:

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B.

Poverty of speechcontent The PMHNP is working with rural primary care providers to increase awareness of mentalhealth disorders in infancy and early childhood. The program includes a session on screening for feeding disorders in infants. If an infant is either observed by the provider or reported by the parent to frequently suck the tongue rhythmically or

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appear to strain with his or her back arched and then swallow, the examiner should consider the possibility of:

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d

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D.

Inadequate emotional attachment

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Which of the following is a true statement with respect to avoidant/restrictive food intake disorder?

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e d

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B.

Approximately 70% of infants who persistently refuse food continue tohave some eating problems during childhood. Regarding pediatric suicide, which of the following is a true statement?

Selecte

d

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A.

Worldwide, suicide very rarely occurs in children who have notreached puberty. The PMHNP is working with a couple who has been trying for years to conceive and is now ready to pursue adoption as an option. They are considering all possibilities; private vs. government-mediated adoption, adopting from another country, adopting a child of adifferent race or ethnicity, adopting an older child rather than an infant, and adopting a child who is currently in foster care vs. one who lives in an orphanage. While counseling this couple, the PMHNP advises them that:

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A.

Younger children adopted from foster care settings have the best outcomes The PMHNP is treating Pam, a 13-year-old female, for moderate-to-severe major depressive disorder. In addition to cognitive behavioral therapy, the PMHNP discusses with the patient and her father the plan to begin sertraline, 50 mg daily, then titrate thedose up when tolerance is established. Pam’s father has researched this medication andis concerned because he read about the risk of increased suicidal ideation. The most appropriate response is to tell Pam’s father that:

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e d

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C.

More recent research suggests that this is not accurate and that treatment actually decreases risk of suicide

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Treatment of early-onset schizophrenia can be challenging due to the paucity of evidence-based support for various pharmacotherapeutics and nonpharmacologic interventions. In a recent study comparing olanzapine to clozapine, outcomes were assessed with the Clinical Global Impression of Severity of Symptoms Scale and Schedulefor the Assessment of Negative/Positive Symptoms. Clozapine was found to demonstrate statistically significant superiority in which outcome measure?

Selected A.

Answer: Alleviating

negativesympt oms While counseling the parents of Joshua, a 9-year-old patient with developmental coordination disorder, the PMHNP advised that the treatment will include:

Selecte

d

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A.

Modified physical education The literature indicates that boys whose fathers died before the age of 13 are at a greater risk for the development of depression as compared to controls. This is consistentwith which general theory of depression etiology?

Selecte

d

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r:

D.

Stress- diathesis Standardized instructional programs used in the management of reading disordersinclude all the following except:

Selected

Answer:

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D.

ck-Johnson PsychoeducationalBattery W o o d c o The PMHNP suspects that Wesley, an 8-year-old male, has a reading disorder. In kindergarten his teacher documented some suspicion for a disorder, but throughout firstgrade and now into second grade, he is clearly functioning below expected levels.. He becomes increasingly anxious when asked to read in school. Which aspect of Wesley’s history would support the risk for this diagnosis?

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d

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D.

Attention deficit hyperactivitydisorder

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When counseling the parents of an intersex neonate, the PMHNP recognizes that thecurrent standard of care is to counsel toward:

Selected B.

Answer: Flexible

sexreari ng Jessica is a 26-month-old female who is being evaluated because she will not eat. Her parents report that she just flat out will not eat her meals. Her mother says that she has followed all the pediatrician’s suggestions: she has eliminated any snacks or drinks between meals, and she has offered a variety of foods, including those that Jessica seemed to enjoy previously. Jessica is not sick; has no problems with vomiting or elimination abnormalities. Jessica’s parent say that her pediatrician is not concerned, but they are not comfortable with what appears to be an almost complete absence of food intake. While considering a diagnosis of avoidant food intake disorder the PMHNP knows that any of the following would fulfill the diagnostic criteria except:

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A.

An irritable, apathetic, or anxious affect Rose is a 13-year-old girl who is being evaluated as part of a family assessment; the primary patient is Rose’s 8-year-old brother who is demonstrating behavior of concern and is having a court-ordered evaluation. During the family assessment, it becomes apparent that Rose’s mother is very concerned that Rose is a tomboy. The mother, who is very elegant, is distressed by Rose’s persistent “tomboy” behavior and worries that Rose might become a lesbian, which would be “unacceptable” to the family.More detailed evaluation of Rose reveals that she is experiencing some sexual reflection.She excels at sports and has always preferred rough and tumble play, but she doesn’t see anything wrong with that. She thinks she is sexually attracted to one of her female teachers, and sometimes fantasizes about her. Rose just began menstruating 3 months ago, and while she has had a boyfriend at school, she is not

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